Application of submental island flap in the postoperative repair of oral cancer resection

Abstract

Objective To investigate the efficacy of submental island flap in the postoperative repair of oral cancer resection. Methods A total of 33 patients with squamous cell carcinoma diagnosed by surgery and pathology from December 2015 to June 2018 in Shanxi Provincial Cancer Hospital were randomly selected. Among them, 20 patients without cervical lymph node metastasis (cN0) underwent local tumor enlargement resection+ submental island flap repair; 13 patients with cervical lymph node metastasis (cN+ ) underwent extended tumor resection + cervical lymph node dissection + submental island flap repair + postoperative radiotherapy. Survival curves were drawn by Kaplan-Meier to analyze the survival of patients with cN0 and cN+ 2 years after operation. The incision healing, survival of the infraorbital island flap, postoperative oral shape and function were analyzed. Results All the incisions healed in 33 cases. The survival rate of the inferior temporal flap was 93.94% (31/33), and the area of the inferior island flap was 4.0 cm×2.5 cm to 8.0 cm×4.0 cm, and the submental flap provided a better facial shape. The internal opening flap was found to be oral mucosa 6 months after surgery, and the flap showed a beard falling off and the color turned rosy and similar flap color with the surrounding skin in male patients. During 2 years of follow-up, there were 3 cases lost to follow-up and 3 cases of death among the 20 patients with cNo; and the 2-year mortality was 15.00%. There were 2 cases losted follow-up and 3 cases of death among the 13 patients with cN+ ; and the mortality rate was 23.08%. There was no significant difference in the 2-year survival curve of patients with or without cervical lymph node metastasis (χ2=0.33, P>0.05). Conclusions Submental island flap repair has good application value in patients after oral cancer resection. The survival rate of the first-stage repair flap is high, and the operation is simple. However, the surgical indications should be strictly controlled. Key words: Oral cancer; Submental island flap; Lymph node dissection